Epilepsy research · 2026
Validation of a focal seizure screening tool in Malaysia: A multicentre study.
СтатьяМногоцентровое исследованиеВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Jamil Mohd Fadzly Amar, Schee Jie Ping, Fong Si Lei, Soon Ming Yi, Chin Chen Joo, Hung Stefanie Kar Yan, Chia Yuen Kang, Hor Jyh Yung, Law Wan Chung, Chew Sin Hong, Tan Hui Jieh, Jan Tan Hui, Khoo Ching Soong, Faizal Amirah, Yoong Hui Qing, Lim Kheng Seang, Looi Irene
Аннотация
BACKGROUND: Accurate classification of seizure types guides diagnostic investigations and antiseizure medication (ASM) selection, and is particularly critical in resource-limited settings. We validated a pragmatic three-item focal seizure screening tool (aura, unilateral motor phenomena, oral automatisms) intended for rapid use by non-specialist clinicians.
METHODS: Through a multicentre cross-sectional study spanning from 1 August 2024-31 August 2025, we recruited consecutive adults (≥18 years) with neurologist-confirmed seizure types at seven public hospitals in Malaysia. Clinicians applied the tool and finalized the scores (0-3). Diagnostic accuracy was evaluated using receiver operating characteristic analysis and area under the curve (AUC). Sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), and negative predictive value (NPV) were calculated at every cut-off score, respectively.
RESULTS: Among the 428 participants (mean age 36.4 ± 14.6 years), 83.41% had focal seizures. The tool achieved an AUC of 0.751 (95% CI 0.688-0.815; p < 0.001). A cut-off score of ≥ 1 yielded high sensitivity (84.0%) and fair specificity (59.2%), with LR + of 2.06 and PPV of 91.19%, supporting its role for screening. A cut-off score of ≥ 2 improved specificity to 88.73% and PPV to 94.74%, making it suitable for diagnosis.
CONCLUSIONS: The three-item focal seizure screening tool is feasible, rapid to administer, and may assist general clinicians in classifying focal-onset seizures. Cut-off scores can be selected according to clinical priorities, namely, sensitive case-finding versus high-specificity confirmation.
METHODS: Through a multicentre cross-sectional study spanning from 1 August 2024-31 August 2025, we recruited consecutive adults (≥18 years) with neurologist-confirmed seizure types at seven public hospitals in Malaysia. Clinicians applied the tool and finalized the scores (0-3). Diagnostic accuracy was evaluated using receiver operating characteristic analysis and area under the curve (AUC). Sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), and negative predictive value (NPV) were calculated at every cut-off score, respectively.
RESULTS: Among the 428 participants (mean age 36.4 ± 14.6 years), 83.41% had focal seizures. The tool achieved an AUC of 0.751 (95% CI 0.688-0.815; p < 0.001). A cut-off score of ≥ 1 yielded high sensitivity (84.0%) and fair specificity (59.2%), with LR + of 2.06 and PPV of 91.19%, supporting its role for screening. A cut-off score of ≥ 2 improved specificity to 88.73% and PPV to 94.74%, making it suitable for diagnosis.
CONCLUSIONS: The three-item focal seizure screening tool is feasible, rapid to administer, and may assist general clinicians in classifying focal-onset seizures. Cut-off scores can be selected according to clinical priorities, namely, sensitive case-finding versus high-specificity confirmation.